Healthcare Provider Details

I. General information

NPI: 1871034686
Provider Name (Legal Business Name): BRANDEY CORDES MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2017
Last Update Date: 03/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 10TH ST SE SUITE 200
CEDAR RAPIDS IA
52403-2414
US

IV. Provider business mailing address

202 10TH ST SE SUITE 200
CEDAR RAPIDS IA
52403-2414
US

V. Phone/Fax

Practice location:
  • Phone: 319-399-2022
  • Fax: 319-450-7731
Mailing address:
  • Phone: 319-399-2022
  • Fax: 319-450-7731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number00399
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: